The importance of training lay persons and experts alike in emergency medicine and in particular in the resuscitation of accident victims, victims of heart attacks and the like has long been recognised. Therefore, training devices have been on the market for some years now, which substantially faithfully simulate a victim or patient requiring resuscitation, at least in the chest region, and on which the procedures required for resuscitation can be carried out for training purposes. Such resuscitation procedures include a series of preparatory procedures such as establishing lack of consciousness, for example by shaking, opening the air passages and establishing lack of respiration, delivering a few quick breaths of air to the patient by means of the mouth-to-mouth method or by means of a respiration mask, establishing absence of pulse, and so forth. The actual cardiopulmonary resuscitation procedure (CPR) then involves heart massage and artificial respiration which is precisely matched thereto, using the mouth-to-mouth method or using a respiration mask.
Correct performance of the CPR procedure is a matter of major importance as mistakes can result not just in injury to the patient but in particular lack of success in the attempted resuscitation. For that reason, instruction in CPR by means of the above-mentioned training devices must be closely monitored by experts and doctors and the persons receiving such instruction received their certificate of competance in the resuscitation procedures only when they have been able to carry out correctly at least 90% of the resuscitation procedures which they were required to perform in the course of testing. As training and testing in CPR procedures is a time-consuming process, which is a matter of disadvantage in particular in regard to the highly qualified experts and doctors who are to supervise the trainees and is therefore an obstacle to the wider spread of training in CPR procedures, various instruction systems and methods have been put forward, in which training is effected by means of computer-controlled audio-video equipment. A training system of that kind, as set forth in U.S. Pat. No. 4,360,345, seeks to replace the trainer or doctor completely or at least substantially, and to provide that the function of the trainer or doctor is carred out by a computer-controlled audio-video system which is capable of analysing resuscitation procedures carried out on a training device, establishing whether such procedures have been correctly or incorrectly performed, and, depending thereon, giving the trainee audio-visual instructions. Such instructions include inter alia realistic visual representations on the picture screen of a display device, which show the correct mode of operation in the resuscitation process, as well as spoken instructions which explain the correct method of operation and which also draw the attention of the trainee to the errors and mistakes that he has made. In the course of training, interaction between a trainee and the system repeatedly requires the trainee to operate the keyboard of the computer in order to continue with the training exercise.
Although that kind of instruction system can substantially avoid the need for the co-operation of trainers or doctors when carrying out the CPR procedures in a training situation, that system however does not satisfy all the requirements for realistic performance of a resuscitation procedure, due to the necessary interaction between the trainee and the system, which also includes operations which are not carried out directly on the training device. For, by virtue of having to carry out intermediate operations on the computer keyboard, the trainee is prevented from going straight through the resuscitation procedure even if the individual operations involved in resuscitation have otherwise been correctly carried out. In particular however this known instruction system is very expensive due to the level of apparatus expenditure which it involves, which has had a deterrent effect on the increased use thereof and which means that the aim that it seeks to achieve, namely making CPR accessible to a considerably larger number of the population, cannot be satisfactorily met.
Although the above-discussed instruction system made it possible to achieve an advance in terms of saving time from the point of view of the people required to supervise the test, a considerable amount of time is still involved in qualitative and quantitative evaluation of the resuscitation procedures under test conditions. The procedures are evaluated and judged in those respects on the basis of recordings of the parameters which characterise the various individual resuscitation operations, for example the amount of air supplied per ventilation when performing artificial respiration, the number of ventilations per unit of time, compression of the chest in the heart massage procedure, the duration of the individual compressions, the time sequence of the individual compressions, and so forth. Although the above-discussed instruction system does in fact already permit such recordings to be evaluated and analysed, because the results are already outputted by the computer itself in tabular form and in the form of charts, the results set out in the tables for each individual trainee have to be associated with a given evaluation standard and thus interpreted, which is a onerous and also time-consuming operation. Therefore, in order to evaluate a trainee in a fair manner such as to do justice to the trainee, it is still desirable to represent the recorder parameters which are characteristic in respect of the resuscitation procedures performed by the trainee, in such a way that the assessment thereof is available directly.
Finally, the known instruction system also provides for teaching a sequence of the above-mentioned preparatory procedures such as establishing loss of consciousness by shaking, opening the air passages, establishing respiration, feeling the pulse and so forth. However, the performance of those preparatory procedures is not included in the assessment, that is to say it is not possible subsequently to check whether the sequence and the timing of those preparatory procedures were correct.